护理模式及孕期凝血指标监测对产后出血的影响  

The effects of nursing model and monitoring coagulation index during pregnancy on postpartum hemorrhage

作　　者：王晶[1] 吴芬英[1] 陶国凤 茅利明[2] 邹德胜[3] 

机构地区：[1]中国医科大学绍兴医院产科,浙江绍兴312030 [2]中国医科大学绍兴医院检验科,浙江绍兴312030 [3]中国医科大学绍兴医院肛肠科,浙江绍兴312030

出　　处：《中国现代医生》2017年第21期145-147,151,共4页China Modern Doctor

摘　　要：目的探讨不同护理模式及孕期凝血指标监测对产后出血的影响。方法收集50例孕产妇随机分为观察组和对照组,观察组实行常规护理加三级预防模式,对照组实施常规护理,比较两组患者产后出血情况。检测凝血指标纤维蛋白原、DD二聚体、血浆纤维蛋白降解产物及血小板相关参数,应用血栓弹力图检测仪检测血栓小弹力图相关参数的变化。结果观察组与对照组相比产后出血率明显降低,纤维蛋白原明显降低,两者差异具有统计学意义(P<0.05);而DD二聚体及FDP明显升高。血栓弹力图R值和MA值两组之间无明显变化,但是产后出血组K值明显升高而Angle角明显降低(P<0.05)。与对照组相比产后出血组血小板数PLT和血小板压积PCT明显降低,而血小板平均体积MPV和血小板分布宽度PDW无明显变化。结论产前预防性护理模式及孕产妇凝血指标监测有利于降低产后出血发生率。Objective To investigate the effects of different nursing models and monitoring of coagulation parameters during pregnancy on postpartum hemorrhage. Methods 50 cases of pregnant women were collected and randomly divid- ed into observation group and control group. The observation group was treated with routine nursing and tertiary pre- vention mode. The control group was treated with routine nursing.The postpartum hemorrhage was compared between the two groups. The coagulation indexes of fibrinogen, DD dimer, plasma fibrin degradation products and platelet relat- ed parameters were measured. The changes of parameters related to thrombosis elastic map were detected by thrombus elasticity analyzer. Results Compared with that of the control group,the postpartum hemorrhage rate was significantly decreased and the fibrinogen was significantly decreased in the observation group,and there was significant difference between the two groups（P〈0.05）. While the DD dimer and FDP were significantly increased compared with those in the control group. There were no significant changes in the R value and the MA value of thrombus elastic map between the two groups, but the K value of the observation group was significantly increased and the Angle angle was significantly decreased（P〈0.05）. Compared with those of the controI group, the platelet Count PLT and plateletcrit were significantly decreased in observation group, while the platelet mean volume MPV and platelet distribution width PDW of the obser- vation group had no significant change. Conclusion Prenatal preventive nursing mode and maternal coagulation index monitoring are helpful to reduce the incidence of postpartum hemorrhage.

关 键 词：产后出血 凝血指标 血栓弹力图 护理模式 

分 类 号：R473.7[医药卫生—护理学]